Adult ADD

You may have attention deficit disorder. What it is — and the best ways to treat it

It used to be every antsy little boy. Now, with ads touting the benefits of ADD medications for "distracted" or "restless" adults, you'd think we all suffer from the condition. That's not the case, but millions of grown-ups do have ADD without knowing it, says Kathleen G. Nadeau, Ph.D., a Silver Springs, Maryland, psychologist who specializes in treating adults with the disorder. Below, Nadeau answers questions about the condition.

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Just what is adult ADD?

It's a malfunction of parts of the brain, including the portion that controls the "executive functions": the ability to organize, to remember what you were asked to do and to finish a task. If the person is also fidgety, then we say that she has attention deficit hyperactivity disorder (ADHD).

Why are we hearing so much about this now?

For one thing, more children are being properly diagnosed. Because it's rare to find only one person in a family with the disorder, the parent might then realize she has the same problems. Also, life is very high-demand these days, which is extra challenging for people with ADD.

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Causes and Symptoms of Adult ADD

What causes the disorder? And how common is it?

ADD is genetic. It may not get diagnosed until you're an adult, but you've had the problem your whole life. As for numbers, experts put the figure at about 4 percent of adults, though it may be even higher.

More men than women?

No, it hits both sexes equally. Actually, that's probably the case with children too; we think of it as a boy's disease because we have defined it in terms of the way boys act ‑- being disruptive at school, for example. By the teen years, however, and then on into adulthood, just as many girls and women report ADD symptoms.

What are the symptoms?

The main thing I hear from patients is that they have trouble managing their daily lives. They get distracted or procrastinate. They struggle with disorganization. They have poor time-management skills. They are forgetful. They have difficulty multitasking. ADD mothers who have jobs outside the house struggle more than dads because it's usually the moms who are trying to manage work, home and child rearing. And many may be raising kids with attention deficit as well.

But not everyone who puts things off or has a messy house has ADD...

Right. We all have symptoms of it from time to time. Some of us just don't get around to tidying up till company's coming or until we can't find that overdue video. People may say, "Oh, my desk is such a disaster ‑- I must have ADD!" But it's not that simple. Those who truly have the disorder wish that they could finish a task ‑- they're struggling with the problem even when their lives aren't particularly stressful ‑- and it's on the degree of their struggle that the diagnosis is made.

So if you're a high achiever, you probably don't have it?

That's a big misconception. You have to look at how much effort it takes for you to get something done. I once diagnosed ADD in a physician who told me that during medical school, he got so distracted in the dorms that, before exams, he would have to rent a hotel room in order to study. Friends would tease him about it, but, he says, "I had to work three times as hard as they did." Even now, he says, "They go play golf while I'm still working."

If you suspect you have the disorder, what should you do?

For a proper diagnosis, you need to find a therapist ‑- a psychologist or a psychiatrist ‑- who has expertise in the area. The national nonprofit group Children and Adults with Attention-Deficit/Hyperactivity Disorder (chadd.org; 800-233-4050) can provide a list of specialists, as well as information about the disorder. Many adults find that medication helps tremendously with the brain's executive functions. A psychiatrist (an M.D.) can prescribe one of the drugs directly; psychologists often refer their patients to a physician for medication. Unfortunately, most people get nothing but a prescription; best is a combination of drugs and counseling or coaching to build the skills that ADD patients need.

Pills That Help

Types: The most commonly prescribed are stimulants (brand names: Ritalin, Adderall, Concerta). There's also a newer drug, Strattera, that is not a stimulant.

Benefits: Studies show that drugs help 70 to 80 percent of ADD patients over the short term. But counseling is also important, say experts.

Drawbacks: In 2004, the FDA issued a warning about potential liver injury associated with Strattera. Also, the drugs may cause side effects, such as sleep problems. The stimulants are controlled substances, so your doctor must write a new prescription every month.